Supporting each other through the journey

Written by Blog Admin
29 Oct

Struggling to conceive is tough enough, but maintaining relationships while undergoing the ups and downs of fertility treatment has its own set of challenges.


At a glance

  • A fertility journey can be emotionally and physically taxing, so building up a good support network is essential
  • Forming relationships with your care providers is invaluable
  • When tackling infertility as a couple, supporting your partner is key

Whether you’re one of the 15 per cent of Australian couples struggling to conceive, are in a same-sex relationship or single, the mix of emotions that accompanies the need for any type of assisted reproductive treatment can be intense and unexpected. While intervention can offer much-needed help and hope, the financial, emotional and physical stresses can bring with them feelings of frustration, uncertainty, anxiety and lack of confidence.

“Going through any form of fertility treatment can be taxing both emotionally and physically,” acknowledges Melbourne-based obstetrician, gynaecologist and fertility specialist Dr Joseph Sgroi. “Which is why it’s important to surround yourself with people who are going to support you through the process.”

For couples, this may mean involving your partner both physically and emotionally – inviting them to appointments, discussing options and tackling ‘what ifs’ together – and for singles, it’s about sharing your journey with your closest friends and family members. Sgroi also emphasises the importance of building up a strong relationship with your care providers. “The key is having a good support structure – with your doctor, but also with the team that supports them – counsellors, nurses and even scientists!”

Don’t ever be afraid to ask questions! And, talking through the experience with others can help.

 

When you’re playing a support role


When navigating the fertility journey, the majority of fertility treatment is undertaken by the woman, physically. However, both partners may experience psychological stress of different levels and at varying times throughout the treatment.

“Blokes in particular can feel a lot of isolation through the whole fertility journey, because some are only involved in such a small part,” warns Dr Sgroi. “It’s really important that both people are being supported throughout the whole process.”

Let’s not forget the added stress on relationships.  There are two types of sex – reproductive sex and recreational sex. Make sure you’re having lots of recreational sex which may just turn into reproduction if it’s timed with ovulation.

With reproductive sex often evolving into something quite mechanical – “it can become a job!” says Sgroi –  enjoyment, spontaneity and romance might be replaced with purpose, function and routine. This can be especially challenging when paired with feelings of disappointment, failure and even anger when intercourse doesn’t achieve conception.

 

Keep the following communication tools in mind when tackling a fertility journey as a couple: 

  • Make agreements around sex and intimacy in advance so it feels less rigid in the moment – for instance ‘during ovulation weeks we’ll have sex every other day’. A calendar can help
  • Agree to set some fertility talk-free time. When it feels all-consuming, taking a ‘holiday’ from the topic – even for a few weeks – can be healthy
  • Put a time limit on regular fertility-related discussions. This may just mean tackling part of the issue rather than having the same discussion every time you’re in a room together
  • Make sure you take some time out to enjoy the life you have together now as a couple, rather than only looking to the future


Being aware of the way you communicate – both around sex, but also about fertility in general – is essential in dealing with the issues you may face. Still struggling to find that person to chat to? 

 

Sources
https://www.ivf.com.au/sites/default/files/attachments/ivfaustralia-res…
https://www.health.harvard.edu/newsletter_article/The-psychological-imp…
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/infe…

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We hope this article was informative and useful to you. If you have any questions or feedback, feel free to get in touch at info@blogivf.com.au.



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Post mortem sperm retrieval – a matter of life and death

Further to his interview on Channel 9’s 60 minutes programme, Dr Ben Kroon of Queensland Fertility Group discusses the topic of post mortem sperm retrieval.

Thankfully for the vast majority of people, post mortem sperm retrieval will never become a reality.

It is an extremely complex and challenging area of reproductive medicine, involving retrieval of sperm after a man’s death so that it can be used by his surviving partner.

While new assisted reproductive technologies are allowing more people than ever to fall pregnant and start the family they desire, the law, at times, does not keep pace with these developments.

In Australia, the law does not specifically address the issue of retrieval and use of sperm after a man’s death. So, while a partner may be sure she knows what her partner ‘would have wanted’, without supporting legal documents explicitly stating those wishes, the question of retrieval and use of sperm is not clear.

In most cases, an urgent court order is needed to retrieve sperm. This is a problem because while the judge is coming to a decision, every hour that the sperm lies in the body after death decreases the chance of finding live sperm.

While 24 hours is the accepted time period for successful retrieval, there may still be a small chance up to 36 hours after death.  However, while retrieval might be medically successful, the court may never permit a woman to use the sperm.

I co-authored a paper, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, in which we surveyed 28 IVF clinics across Australasia to test attitudes towards posthumous sperm retrieval and use.

It appears that directors of IVF units are generally supportive of the practice, given the right circumstances, but that the lack of clear laws makes the response to requests for sperm retrieval very difficult.

Myself, and the papers co-authors, believe that ‘clear, accessible and consistent law in this area would benefit everyone involved, including the medical, legal and societal stakeholders’.

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Men should consider and discuss with their partners whether they would want to father a child after their death, bearing in mind that they could not raise the child, and that the child could conceivably be raised by another man.

I need to be clear that I am not suggesting that more people should have their sperm collected and used after their death.

Personally, I wouldn’t want my sperm to be retrieved and used if I died suddenly, and my wife knows this. But, if couples don’t have the discussion and document their wishes, it is seldom clear what one would have wanted if one dies.

Have you considered discussing post mortem sperm retrieval with your partner?

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In 2007 a local Melbourne paediatrician approached me curious about whether girls conceived through In-Vitro Fertilisation (IVF) and other Assisted Reproductive Treatments (ART) enter puberty earlier than those conceived spontaneously. With the first babies born through IVF now reaching their mid-30s, this query was my early motivation and the catalyst to initiate a study on the effects of IVF and ART on the health and wellbeing of children conceived through these technologies.

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This project was the largest of its kind ever attempted, worldwide.

We found that children conceived by IVF grew into healthy, normal adults when compared to children conceived spontaneously.

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These problems are more common in premature babies and we know a higher proportion of ART babies are born prematurely for reasons still largely unknown. Premature births may be because of the age of IVF mothers, as having a baby in your early 40s is generally harder than having a baby in your late 20s or early 30s.

ART parents might take their children to the GP more often and consequently they are diagnosed at a higher rate. We found ourselves speculating if parents of IVF-conceived children are more protective reducing their baby’s exposure to dust and dirt in turn increasing their risk factor for later allergies.

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What will be done to investigate further?

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We have a responsibility to continue this research and gather further clinical review in long term follow up of those conceived through IVF and other ART. Further research will evaluate their health status and follow up to determine if there are any important lifelong medical or other legacies of IVF.

What does this mean for those considering IVF?

This study provides reassurance to those requiring IVF that there are no apparent substantial negative long term health and wellbeing effects on young adults compared to those spontaneously conceived.

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Learn more about IVF in Queensland, Victoria and New South Wales.



 

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15 years of IVF patients – how have women changed?

The media is increasingly full of stories showcasing the latest 50 year old mum, or the celebrity who has undergone IVF. Even women who have used donor eggs are increasingly more comfortable discussing their medical history.

But, do these sensationalised stories really reflect the changing face of the IVF patient we see every day at our fertility clinic?

At Queensland Fertility Group Toowoomba we decided to assess the reality of these changes. In order to do this we conducted a retrospective study of 1587 women who had undergone IVF between 1998 and 2013 at our clinic in Toowoomba (based in the Darling Downs, west of Brisbane). We know that during this time there has been considerable social change, and we were interested to see how our patients may correspondingly have changed during this 15 year period.

Older women

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Rising obesity

The number of overweight and obese Australians has been gradually increasing for the past 30 years across all demographics – from wealthy, metropolitan suburbs to rural and disadvantaged communities.

An Australian Bureau of Statistics Australian Health Survey identified that between 1995 and 2011/12 the average adult woman’s weight had increased by 4kgs. The report likewise stated that in 2011/12 27% of all females aged 18 and over were overweight with a Body Mass Index (BMI) of 25 to 30.

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Single Women and Same-sex Couples

Shifts have occurred in the structure of families and as a result, we have seen a considerable increase over the past five years in single and same-sex couples accessing donor sperm to start their families.

Looking at the subset of patients where female cause was the sole reason for them having treatment, the proportion of single women and same-sex couples undergoing IVF increased from 2% in 2008 to 22% in 2013.

15 years later

Women attending our fertility clinic in 2013 are significantly older, heavier and have an increased BMI than they did in 1998. However, as women delay child bearing, by choice or circumstance, we need to ensure that there isn’t an unrealistic expectation that medical science can undo the effects of age.

What would you advise?

Unfortunately, we still cannot reverse the aging process, but we can ensure women are given the correct information to help them make informed decisions earlier. For example, the increasing use of the Anti-Mullerian Hormone (AMH) test or as it's more widely known, the egg timer test, can help a Fertility Specialist better assess a woman’s fertility and guide the direction of her fertility treatment.

Many women still remain unaware of the effect of weight on their fertility. We advise weight loss with simple lifestyle changes and, if necessary, dietician support. In addition to boosting a woman’s natural fertility, this can also have a beneficial impact on pregnancy and the health of the child.

This data was presented by Leita Fien, Fertility Nurse, Toowoomba at the 5th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2014) in conjunction with the Fertility Society of Australia Annual Conference held in Brisbane April 4-6, 2014.  Leita would like to acknowledge and thank her co-authors and colleagues Susan Lax, Julie Logan, Jeremy Osborn, and Dr John Esler, Clinical Director QFG Toowoomba.

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